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City’s High Abortion Rate Defies Easy Explanation

At a time when evidence suggests that people in New York City are smoking less, eating better and biking more, one health statistic that has not budged is the abortion rate.

Two of every five pregnancies in the city end in abortion, a statistic that has barely changed in more than a decade. At a news conference last month, Timothy M. Dolan, the Roman Catholic archbishop of New York, called the city’s 41 percent abortion rate “downright chilling.” And on Thursday, State Senator Rubén Díaz Sr. of the Bronx brought up the figure repeatedly as he urged a group of anti-abortion ministers to spread the word that abortion was nothing less than an attack on minorities.

“They might think that we will take over, and that they’ve got to stop us,” said Mr. Díaz, who also is a minister. “What they did, they are killing black and Hispanic children.”

But city health officials and groups that support access to abortion say that behind the 41 percent statistic — nearly twice the national rate — are complex social and legal factors: fewer obstacles to abortion in state law; the absence of mandatory sex education in New York City public schools; the ignorance of people, especially young ones, about where to get affordable birth control; and the ambivalence of young women living in poverty and in unstable relationships about when and whether to have children.

And although the percentage of pregnancies that end in abortion is basically unchanged, a particularly vulnerable group, teenagers, is having fewer babies and fewer abortions.

The hand-wringing has led to a rare moment of synchronicity between the Catholic Church and pro-choice women’s groups, as both say they are disturbed that the rate is so high, but disagree over what to do about it.

“Listening to Archbishop Dolan, I took a little bit of comfort in that he recognizes it is important to bring this rate down,” said Joan Malin, president of Planned Parenthood of New York City. But, she added, “The way we think about these issues is to really step back a bit and say that the major concern or the underlying issue that we think is so important is the high rate of unintended pregnancies.”

The issue came to light with the city health department’s recent release of its annual Vital Statistics report, which showed that 41 percent of pregnancies, excluding miscarriages, in 2009 ended in abortion.

Health experts say the abortion rate is tied to factors like race and income.

“If you look at the pregnancy rates by race and ethnicity in New York City versus nationally, they are essentially the same for black and Hispanic teenagers, and lower for whites,” said Susan Craig, a spokeswoman for the city’s health department.

There were 126,774 births, 11,620 miscarriages and 87,273 abortions in New York City in 2009. Despite the contention of some critics that New York, with its liberal abortion laws, is a destination state for abortion, nonresidents accounted for only about 7,000 of these abortions. (Factoring out nonresidents does not alter the 41 percent abortion rate, because 10,000 nonresidents also gave birth in the city.)

The little-changed abortion rate figure is a commonly cited statistic. But it masks large changes in fertility among teenagers.

Since 1996, the number of babies born to teenagers has fallen by 39 percent. The number of abortions has fallen by more than 16 percent, even though the population of teenagers has risen modestly. Ninety percent of the teenage mothers were not married, according to health department estimates.

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In the Bronx on Thursday, State Senator Rubén Díaz Sr. called abortion an attack on minorities. “They are killing black and Hispanic children,” he said.Credit
Ruby Washington/The New York Times

In that age group in 2009, the rate of abortions was strikingly high for blacks (74 percent), followed by whites (66 percent) and Hispanics (53 percent). The rate was also very high for Asians (74 percent), though they were much less likely to become pregnant.

The drop in teenage pregnancies and abortions, however, was not enough to significantly alter the overall abortion rate. Most abortions, like most pregnancies, occurred among women in their 20s. Women in their 30s had abortions 29 percent of the time, and women 40 and older about a third of the time. Unmarried women accounted for 84 percent of abortions in 2009.

New York State law does not place as many restrictions on abortion as laws in some other states, like requiring parental consent for minors, or requiring women to undergo counseling that discourages abortion or to go through a waiting period.

According to Rachel Jones, a senior research associate at the Guttmacher Institute, which studies reproductive health issues, the high rate of unwed pregnancy and abortion among poor women is a sign of ambivalence. They are torn, she said, between the desire to have a baby and the realization that it would be hard to bring up a child as a single mother.

“In the U.S., most women want to have kids,” Ms. Jones said. “If you don’t have a lot of money, when is the responsible time to say, Now I want to have a child? How long are you supposed to put this off?”

That inner conflict could be seen recently in several women coming out of Planned Parenthood’s Margaret Sanger Center, a family planning and abortion clinic in Greenwich Village.

A 17-year-old girl there to pick up a friend said she had had an abortion in May. It was her second; the first was when she was 15. The girl said she sometimes used condoms. “But I wasn’t using them when I got pregnant,” she said. “I might use them more now, but I don’t know.” Like the other women outside the clinic, she asked not to be named to preserve her privacy.

A 20-year-old woman being helped by two male friends said she had her first abortion at 16, and also had a 7-month-old child. “It was an accident,” the woman said. “I used a condom every time, but I already have a kid, and I’m not ready for another one.”

Another woman, who was 22, said she had become pregnant after not using birth control because a doctor had told her she was infertile. “I’ve always been against abortion,” the woman, who lives on Staten Island, said. “But if I had a kid now, it would have a terrible life. I’d rather wait.”

The health department distributes a pocket-size guide to clinics where teenagers can get medical care and low-cost or free contraception (information that is also available through the city’s 311 hot line).

It has provided training in issues like protecting confidentiality and dispensing contraception to 50 clinics serving 32,000 teenagers a year in the neighborhoods with the highest pregnancy rates among teenagers.

School-based classes use role-playing to help teenagers “learn how to negotiate maybe saying, I don’t want to have sex,” said Deborah Kaplan, assistant commissioner of the health department’s bureau of maternal, infant and reproductive health.

Condoms are distributed through health offices at every public high school, Ms. Kaplan said.

Archbishop Dolan agreed to speak out with other religious leaders at a news conference last month at the invitation of the Chiaroscuro Foundation, an anti-abortion group coordinated by an investment banker active in conservative causes, according to the archbishop’s spokesman, Joseph Zwilling.

The archbishop “reaffirmed and was looking to spread the word as well of the archdiocese’s longstanding commitment that any woman who is pregnant and in need can come to the Archdiocese of New York for assistance,” Mr. Zwilling said.

On Thursday, Senator Díaz, who, like the archbishop, advocates abstinence and not condom use, called abortion “a business,” and his wife, Leslie, said that handing out condoms to teenagers promoted promiscuity. “Abortion is the law of the land, and there’s nothing we can do about that,” she said. “But we can try and reduce the number, and that’s what our main goal is: to make it rare.”

Juliet Linderman contributed reporting.

A version of this article appears in print on February 4, 2011, on page A17 of the New York edition with the headline: Behind City’s Stubbornly High Abortion Rate, an Array of Social and Legal Issues. Order Reprints|Today's Paper|Subscribe